Bilateral Descemet Membrane Endothelial Keratoplasty in an Infant With Congenital Hereditary Endothelial Dystrophy.

PURPOSE

Descemet membrane endothelial keratoplasty (DMEK) has been reported in children but not in infants. We evaluate the outcomes and complications of DMEK for an infant with congenital hereditary endothelial dystrophy.

METHODS

A 3-month-old male infant with congenital hereditary endothelial dystrophy underwent unilateral DMEK, which was complicated by incomplete graft unfurling. Bilateral DMEK was then performed successfully. The visual acuity, pachymetry, corneal transparency, and complications were assessed over 3 months of follow-up.

RESULTS

At 3 months postoperatively, the nystagmus had resolved and visual acuity improved from 20/2000 to 20/270 in each eye. Pachymetry, which had been unmeasurable preoperatively, was 695 μm in the right eye and 678 μm in the left eye. On examination, there was improvement in corneal transparency bilaterally. There were no postoperative complications.

CONCLUSIONS

We demonstrate that DMEK is feasible in infants and propose that it should be considered in the treatment of corneal endothelial disorders of infancy. In theory, DMEK might confer improved visual potential and lower risk for rejection compared with other corneal transplantation techniques, although further studies in this age group are needed.